In the operating room environment, it is important to prevent cross-contamination between the patient and other personnel. With the increased advent of readily communicable and fatal diseases such as AIDS, the use of protective gowns, masks and gloves has become essential.
In a typical operation in which a patient is to be anesthetized, there is a myriad of equipment which must be handled by doctors, nurses and other operating room personnel. As is to be expected, the operating room personnel may become contaminated with bodily fluids from the patient, for example, blood may accumulate on the gloved hands of any of these personnel. Once a surgical glove is contaminated with a fluid, such as blood, the operating room personnel may encounter difficulty in picking up or holding objects. Since a steady grip is generally required in the manipulation of many pieces of operating room equipment, personnel may have a tendency to remove their protective gloves to properly manipulate the piece of equipment. Removal of surgical gloves or other protective gear creates a risk of the spread of contamination from the operating room personnel to the patient, as well as from the patient to the operating room personnel.
An example of such a potential problem exists with the use of an anesthetic/breather bag (hereinafter referred to as a breather bag) attached to a breathing machine such as, for example, an anesthetic machine. The anesthetic machine combines oxygen for breathing with an appropriate anesthetic for maintaining the unconscious state of the patient. On such a machine, there is a circuit generally comprising a plurality of tubes for the passage of mixed gases from a source through various other devices (such as an absorber cannister and a humidifier) to the patient. Typically, a breather bag is attached to the circuit to hang freely therefrom in a vertical orientation. The breather bag is provided as a supplemental supply of gas to allow the anesthesist some manual control over patient ventilation. The bag preferably has a 1-3 liter volume for use with adults (other sizes being possible for children).
The breather bag is generally constructed of an elastomeric material such as latex capable of being inflated and deflated repeatedly. The exterior surface of the breather bag is generally smooth-surfaced as a result of the latex "dip" method of manufacture. The latex "dip" method requires the use of a mandrel having the shape of the product to be formed. The mandrel is dipped into a liquid supply of latex which collects on the mandrel to form the product. The mandrel is then removed along with the product formed thereon to cure or harden.
In the use of the anesthetic machine, a facial mask is typically attached to the patient end of the circuit for initial delivery of the anesthetic gas to the patient. Once the patient is unconscious, it is preferable to remove the facial mask and insert an endotracheal tube. Prior to removal of the mask, the anesthesist or one of the operating room personnel will inflate the lungs of the patient by squeezing the breather bag several times to pump extra oxygen and anesthetic into the patient. The mask will then be removed, and an endotracheal tube will be inserted into the patient. The patient end of the anesthetic machine must then be connected to the endotracheal tube, and the patient will once again typically be provided with several pumps of oxygen and anesthetic from the breather bag. The patient will then be maintained by the automatic aspects of the anesthetic machine to be supplemented by the breather bag.
As previously indicated above, if the anesthesist or other operating room personnel have surgical gloves that have become contaminated with blood or other fluids, the breather bag will also become contaminated with the fluids. The vertically orientated bag then may become slippery enough that a secure grip thereon is difficult to attain. The operating room personnel may then remove their surgical gloves to obtain a secure grip and pump the breather bag. Once the surgical gloves have been removed, the personnel have subjected themselves to the possibility of contamination. This contamination may then be transmitted from the hand of the person who has pumped the bag to other personnel and other equipment in the operating room.
It is known in the art that the exterior surface of breather bags has some inherent tackiness, as disclosed in U.S. Pat. No. 3,556,097 to Wallace, Jan. 19, 1971. The tacky exterior surface provides some protection against slipping when both the gloved hand and the bag are clean and dry. However, as is known in the art, the bags are usually provided with a light coating of corn starch to reduce the tendency of the bags to stick together during shipping and while being stored. Thus, the inherent tackiness of the external surface is compromised by the corn starch unless washed off. If the corn starch is removed by washing (and assuming the bag is dried) the inherent tackiness of the bag is restored until the bag is contaminated with bodily fluids. Thus, the inherent tackiness of the breather bag exterior surface is insufficient to prevent slippage once the surface becomes wet.
One possible alternative to removing the surgical gloves is to replace the breather bag with a reduced volume version of the bag. A smaller bag allows a person with a wet gloved hand to encircle the bag for a better grip. Unfortunately a smaller bag may not provide sufficient oxygen to the patient without further adjustments (more squeezes) and is thus generally not an acceptable alternative. Therefore, it is desirable to provide a way to reduce the likelihood of cross contamination and specifically to prevent the need for removal of a surgical glove to use a breather bag.
In a non-analogous art, heavy industrial, chemical and electrical gloves, have been provided with roughened exterior surfaces. The roughened exterior surface is formed on the gloves using a mandrel "dip" technique. A mandrel having the shape of the glove is first coated with the material from which the glove is made. Then, prior to allowing the glove to cure or dry, the coated mandrel is dipped into a tank containing an acid or other solution which reacts with the glove material. The reaction between the glove material and the solution results in an uneven and therefore roughened exterior surface on the gloves.
A roughened exterior surface is advantageous when, for example, if a chemical handler wearing such gloves is working with chemicals, the gloves will become contaminated on the exterior surfaces thereof with the chemical. If the handler subsequently desires to do another task such as lift a chemical drum, the wet gloves may slip on the drum. For the sake of safety and to reduce such slipping, the gloves are provided with a roughened exterior surface. The rough surface provides extra contact between the glove and the object being gripped and, therefore, reduces the likelihood of slippage.
However, in the medical equipment art, there is no similarly roughened surgical glove. This is due to the fact that a surgeon needs to have protection against contaminants without loss of dexterity and "touch" of the hands. The roughening of surgical gloves would likely require the use of a thicker glove reducing the surgeon's "touch" and is therefore undesirable. Thus, there is a need for a breather bag with a roughened exterior surface that will allow operating room personnel to manipulate even when wearing a surgical glove contaminated with bodily fluids.